Background: Laparoscopic cholecystectomy has many difficulties which include port Insertion, Dissectionof the Calot’s Triangle , Grasping of the Gallbladder , Wall thickness, Adhesion and extraction of theGallbladder. Aim of the Study: To predict how difficult cholecystectomy will be from assessing the patientpreoperatively which, in turn, help in decreasing the risks on the patients and preventing post-operativecomplications. Patients and Methods: A prospective study conducted in the department of General Surgeryat Al-Ramadi Teaching Hospital for the period of nine months from 15th of May 2018 till the 15th of February2019. It included 60 patients, all of them were undergone laparoscopic cholecystectomy for Gallstone. Patientswith common bile duct calculus, dilated common bile duct, current attack of acute cholecystitis, those withabsolute contraindications to laparoscopic cholecystectomy, The data were collected prospectively to predictthe significance of association with patients’ characteristics. The time of operation was calculated from thefirst port site incision until the last port closure. All the intra operative events were recorded. Conversionsto open cholecystectomy were done by median or subcostal laparotomy according to the surgeon’s decisionand each patient’s condition. Results: In this study, the highest proportion of operations was categorizedas easy (58.3%), 28.3% of operations were considered difficult and 13.3% of them were very difficult. Asignificant association (P < 0.05) between operation difficulty and all of the following characteristics: Aging,obesity, history of previous biliary hospitalization, thickened bladder wall, pericholecystic collection, andlarge stones. Conclusions: The difficult laparoscopic cholecystectomy can be predicted preoperativelybased on number of factors, like: obesity, previous biliary admission, gall bladder wall thickness, ultrasoundfindings (stone size and pericholecystic fluid) and aging process, evaluating of such factors minimize thecomplications of laparoscopic cholecystectomy and conversion to the open procedure.
The research aims to measure the efficiency of health services Quality in the province of Karbala, using the Data Envelopment analysis Models in ( 2006). According to these models the degree of efficiency ranging between zero and unity. We estimate Scale efficiency for two types of orientation direction, which are input and output oriented direction.
The results showed, according Input-oriented efficiency that the levels of Scale efficiency on average is ( 0.975), in the province of Karbala. While the index of Output-oriented efficiency on average is (o.946).
The use of the entrance diffraction hexagon continuous improvement of operations in order to achieve the rationalization of activities, costs and efficiency in the use of available resources and reduce the incidence of damage and waste and recycling, as the accounting information system does not meet the surface production processes oil fields cost management requirements in the measurement and evaluation of the costs of each activity and development of indicators to evaluate the efficiency and effectiveness of production processes and to cover the shortcomings of currently approved by the company so cost accounting system has Find addressed the use of strategic cost management techniques, including the entrance diffraction hexagon for c
... Show MoreIn this work, solid random gain media were fabricated from laser dye solutions containing nanoparticles as scattering centers. Two different rhodamine dyes (123 and 6G) were used to host the highly-pure titanium dioxide nanoparticles to form the random gain media. The spectroscopic characteristics (mainly fluorescence) of these media were determined and studied. These random gain media showed laser emission in the visible region of electromagnetic spectrum. Fluorescence characteristics can be controlled to few nanometers by adjusting the characteristics of the host and nanoparticles as well as the preparation conditions of the samples. Emission of narrow linewidth (3nm) and high intensity in the visible region (533-537nm) was obtained.
The relationships between the related parties constitute a normal feature of trading and business processes. Entities may perform parts of their activities through subsidiary entities, joint ventures and associate entities. In these cases, the entity has the ability to influence the financial and operating policies of the investee through control, joint control or significant influence, So could affect established knowledge of transactions and balances outstanding, including commitments, and relationships with related to the evaluation of its operations by users of financial statements, including the risks and opportunities facing the entity assess the parties. So research has gained importance of the importance of the availability
... Show Moreالمستودع الرقمي العراقي. مركز المعلومات الرقمية التابع لمكتبة العتبة العباسية المقدسة
The present study is concern with the interaction between the naidid worms diversity and the species of aquatic plant within which the worms found . For this purpose, two species of aquatic plant were used, Ceratophyllum demersum and Eichhornia crassipes. 12 samples of aquatic plants were collected , as one sample monthly for a period from September 2012 to September 2013 from different site on Tigris river within Baghdad City. From C. demersum, 1428 individuals, were sorted during the study period, related to 17 species. 12 species of subfamily Naidinae which are Chaetogaster limnaei , C. diastrophus , Ophidonais serpentine , Dero ( Dero) digitata. , D.(D.) evelinae , Nais pseudobtosa , N.simplex, N.stolci , N.Paradalis , N.elingiu
... Show MoreA significant amount of apiaries is destroyed in most areas of Iraq by attacking of the hornet
Abstract
Despite the fact of the importance and effectiveness of supporting the pricing policy for agriculture sector in Iraq, but this policy has stopped in supporting those agriculture production needs, and it was confined to support the final product only, and supporting the strategic corps exclusively after the U.S. Invasion in 2003, but after 2008 the state has returned to support some of this policy activities through providing financial loans through the agricultural initiative campaign, with trillions of iraqi dinars without any use, also providing support to some of the agricultural production needs such as fertilizers , tractors and agricultural combines, in addition supporting the pricing policy for the
... Show MoreA pure posteriorly posterior communicating artery (PCoA) aneurysm represents a surgical challenge. This is mainly when there is a need for good exposure of the aneurysmal neck, sac, PCoA, and anterior choroidal arteries. Ruptured pure posteriorly directed PCoA aneurysm imposes significantly extra challenge as the surgeon undergoes dissection through a tight brain. Even with measures commonly used to attain brain relaxation like the lumbar drain and cisternal fenestration. Here, we describe a technique for posterior temporal pole mobilization (TPM) as an integrated part of microsurgical clipping of ruptured pure posteriorly directed PCoA aneurysms. This technique is implicated in twenty-three successive cases of ruptured PCoA aneurys
... Show More